Correlation analysis between the changes of anterior segment parameters and refractive shift after phacoemulsification and intraocular lens implantation

doi:10.3877/cma.j.issn.2095-2007.2017.04.002

Abstract

Abstract:

Objective

Correlation between refractive index shift and changes of ocular anterior part parameters in cataract patients before and after surgery.

Methods

The clinical data of 40 patients (42 eyes) who underwent phacoemulsification and IOL(IOL) implantation in First Affiliated Hospital of Guangxi Medical University from May 2016 to January 2017 were selected and followed up. Before and after operation, one day, one week after surgery and one month after the operation, both the application of Pentacam anterior segment analysis system with the measurement of corneal curvature (KM), anterior chamber volume (ACV), anterior chamber depth (ACD) and anterior chamber angle (ACA) and other parameters, and record the refractive status.All data were tested by normality. Single factor repeated measures analysis of variance was used to compare the same index at different time points before and after operation. A single sample t-test was used to compare the postoperative diopter with the target diopter. Pearson linear correlation analysis was used to analyze the relationship between postoperative refractive changes and ACD changes, ACV changes, ACA changes and KM changes.

Results

By optometry, it was showed that the average refraction was (-0.43±0.50)D at 1one day after surgery, (-0.71±0.54)D at one week after surgery, (-0.50±0.46)D at one month after surgery. The diopter at one d after surgery was closed to the target diopter -0.50 D, while there were statistically significant increases of the degree of the myopia at one week after surgery. When one month after surgery, the diopter was closed to the target diopter again, where there was no statistically significant difference with the diopter one d after surgery(P>0.05). Pentacam system showed that the average ACD was (3.99±0.53)mm at one day after surgery, (3.81±0.50)mm at one week after surgery, (3.53±0.38)mm at one month after surgery; the average ACV was (152.05±26.75)mm³ at one day after surgery, (139.71±26.65)mm³ at one week after surgery, (127.83±25.37)mm³ at one month after surgery; the average ACA was (45.44±6.45)degree at one day after surgery, (43.83±5.81)degree at one week after surgery, (43.82±4.58)degree at one month after surgery. There was statistically significant decrease between one week, one month and the first day after surgery in the ACD and ACV (P<0.05), but there wasn′t statistically significant difference between one week, one month and the first day after surgery in the ACA (P>0.05). The average KM was (42.74±1.06) before surgery, (42.75±1.05) at one day after surgery, (42.73±1.00) at one week after surgery, (42.73±1.01) at one month after surgery, there wasn′t statistically significant difference in patients before and after surgery(P>0.05). Compared with the one day after surgery, the changes of diopter of one week, one month after surgery were (-0.28±0.60)D and (-0.07±0.68)D. The positive correlation was found between the changes of diopter and changes of ACD (r_{one week}=0.73, r_{one month}=0.83; P<0.05), also between the changes of diopter and changes of ACA at one week after surgery (r_{one week}=0.31, P<0.05), but not found at one month(r_{one month}=0.14, P>0.05). There was no statistically significant correlation between the changes of diopter and the changes of ACV, neither the changes of KM(r_{one month}=0.21, 0.19; P>0.05).

Conclusion

The phenomenon of early refractive shift may exist in the cataract patients whose diopter of one day after surgery was closed to the target diopter, then became myopic shift, finally decrease at one month after surgery. The early refractive shift is closely related with the changes of ACD.

Key words: Phacoemulsification and IOL implantation, Refractive shift, Anterior segment changes

Wei Wei, Huiyi Zuo, Shaojian Tan. Correlation analysis between the changes of anterior segment parameters and refractive shift after phacoemulsification and intraocular lens implantation[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2017, 07(04): 151-157.

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References 56

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时间	屈光度(D)	ACD(mm)	ACV(mm³)	ACA(度)	KM
术前	－1.07±1.91	3.04±0.49	111.93±37.48	42.70±2.65	42.74±1.06
术后1 d	－0.43±0.50^*	3.99±0.53^*	152.05±26.75^*	45.44±6.45^*	42.75±1.05
术后1周	－0.71±0.54	3.81±0.50^*	139.71±26.65^*#	43.83±5.81	42.73±1.00
术后1月	－0.50±0.46^*	3.53±0.38^*#	127.83±25.37^*#	43.82±4.58	42.73±1.01
F值	3.15	31.47	14.16	2.56	1.61
P值	<0.05	<0.05	<0.05	<0.05	>0.05

时间	屈光度(D)	ACD(mm)	ACV(mm³)	ACA(度)	KM
术前	－1.07±1.91	3.04±0.49	111.93±37.48	42.70±2.65	42.74±1.06
术后1 d	－0.43±0.50^*	3.99±0.53^*	152.05±26.75^*	45.44±6.45^*	42.75±1.05
术后1周	－0.71±0.54	3.81±0.50^*	139.71±26.65^*#	43.83±5.81	42.73±1.00
术后1月	－0.50±0.46^*	3.53±0.38^*#	127.83±25.37^*#	43.82±4.58	42.73±1.01
F值	3.15	31.47	14.16	2.56	1.61
P值	<0.05	<0.05	<0.05	<0.05	>0.05

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